The price of gasoline may make the evening news, but what's really hurting working-class Montanans today is the cost of health care and health insurance. The rising cost of health insurance has far outpaced other items in Montana.

That's one reason the Children's Health Insurance Program (CHIP) is so critical to Montana families, and especially its rural families. Rural families, a recent report by the Carsey Institute at the University of New Hampshire shows, are now more likely to rely on public health insurance than urban children.

CHIP nationally insures roughly six million children whose families earn too much to qualify for Medicaid but too little to afford private health insurance. In Montana, it currently covers approximately 13,000. Enacted in 1997, the program has been a resounding success. Together with Medicaid, it has reduced the rate of uninsured children nationally by 21 percent over the past 10 years. The program, however, is set to expire at the end of September, and Congress will soon begin debate on its reauthorization. The debate turns largely on funding. Congress wants to increase funding for this program to $15 billion annually. The Bush Administration is offering $5 billion annually. Government estimates indicate that maintaining the current funding level could result in at least 1.5 million children losing coverage by 2012.

For Montanans, CHIP is increasingly important. For the state's rural families, it is even more so. Unemployment may be at historic lows in the state, but the types of jobs people are taking are no longer the lifetime "good" jobs that offer a decent wage with benefits. As these well-paid jobs are replaced with lower-paying, less stable work, benefits such as health care disappear. Montana is not alone in this pattern. In rural areas all across the country, families are finding it harder to make ends meet on their lower wages and less stable employment. Along with rising child poverty and continued underemployment among adults, more families are now turning to public health insurance as well. As the Carsey Institute report finds, the share of low-income rural children covered by the CHIP and Medicaid increased from 38 percent in 1998 to 54 percent in 2005.

Compounding these economic changes is limited access to social services in rural areas. Whereas uninsured urban children can use a public health center for their health care needs, rural areas in Montana and elsewhere have few or no such services. On a per capita basis, there are three times as many pediatricians in urban areas as in rural areas. Instead, these families are forced to turn to high-cost emergency rooms. Clearly, the costs of uninsurance go far beyond a single family's budget.

Montana lags far behind national averages in insuring its rural children, making CHIP even more critical to the state. Among rural children in the state, 17.2 percent are uninsured. Nationally, 11 percent are uninsured. The Carsey Institute puts Montana fourth behind Colorado, Texas, and New Mexico in the states with the highest percentage of uninsured rural children.

Providing health insurance to children is an investment in the future, and the majority of Americans, according to a recent survey, say the federal government should guarantee health insurance for children, and many are willing to pay higher taxes to do so. The rapid increase and high rate of public-sector health insurance for children underscores how important the Medicaid and CHIP programs are for all Americans, and especially rural Americans. It is difficult to think of a more effective investment in our country's future than taking steps to ensure that all of our children grow up healthy.

Doug Rauthe is executive director of Northwest Montana Human Resources.